Small Intestinal Bacterial Overgrowth A Problem For Scleroderma Patients PDF Print E-mail
Tuesday, 02 July 2013 21:31
More than a third of patients with systemic sclerosis and intestinal symptoms have an increase in gastrointestinal tract bacteria, an alteration in the type of gut microbes present, or both, based on data from a French study presented at the annual European Congress of Rheumatology.

Small intestinal bacterial overgrowth (SIBO) was found to affect 14 (38%) of 37 patients included in the study. These patients had been recruited from a larger group of 120 scleroderma patients who complained of gastrointestinal symptoms over a 2-year period. "SIBO can compromise patients’ quality of life and be responsible for mortality," study investigator Dr. Marie Tauber said. SIBO can cause GI symptoms such as bloating, diarrhea, malabsorption, weight loss, and malnutrition, which may have a significant impact on patients’ overall prognosis, she noted.

Dr. Tauber, a dermatologist who took part in the research as part of an internship within the rheumatology department of the Hôpital Cochin in Paris, explained the three goals of the study. The first was to examine the prevalence of SIBO in patients with systemic sclerosis exhibiting GI symptoms, and the second was to identify subsets of patients who might be at increased risk. A third goal was to observe the impact of optimal SIBO treatment on the patients’ conditions.

The median age of participants was 59 years, and 79% were women. The median disease duration was approximately 10 years, and 49% of patients had diffuse cutaneous disease. A diagnosis of SIBO was based on positive hydrogen and methane breath tests, and blood assays were used to assess the presence of malabsorption.

The researchers also administered two questionnaires – the generic SF-36 (Short Form 36) Health Survey and the disease-specific UCLA SCTC GIT (University of California, Los Angeles, Scleroderma Clinical Trial Consortium Gastrointestinal Tract Instrument) – to patients at the time of their breath testing visits.

All patients with SIBO were treated with a rotating regimen of amoxicillin, ciprofloxacin, and metronidazole, each given for 1 month at a time. Breath tests, as well as the UCLA SCTC GIT, were repeated. Fewer than 50% of patients had a negative breath test after antibody treatment, which highlighted a need to repeat the test after antibiotic treatment to determine whether a second course is required, Dr. Tauber noted.

Three clinical parameters separated patients with and without SIBO: longer disease duration (11 vs. 7 years; P = .02), lower prevalence of anti-topoisomerase I antibodies (Anti-Scl-70 Ab, 7% vs. 39%; P = .04), and higher prevalence of definite pulmonary arterial hypertension (PAH, 21% vs. 0%; P = .04). Total UCLA SCTC GIT scores were higher in patients with SIBO than in those without it (0.79 vs. 0.31; P = .03). SIBO-affected patients also were more likely to have weight loss of 5% or more (43% vs. 8%; P = .03).

Given the small number of patients, it is difficult to draw firm conclusions from these data, and larger studies are needed, Dr. Tauber observed. However, the findings suggest that there may be factors associated with SIBO that could be targeted in an intervention program.

Source: Family Practice News
 
More articles :

» Scleroderma in Children: Emerging Management Issues

Saumya PandaDepartment of Dermatology, KPC Medical College, Kolkata, IndiaDate of Web Publication: 21-Jul-2010Abstract         Scleroderma is a set of rare connective tissue diseases of unknown etiology. It is...

» Researchers Testing Intense Pulsed Light As An Alternative Treatment for Telangiectatases

Telangiectatases are knot-like clusters of blood vessels on the skin which can occur in 30 to 50 per cent of patients with Systemic Sclerosis, also known as . Telangiectases tend to occur on the face, neck, and upper limbs and can cause...

» Positive Phase II Results for AIMSPRO In Scleroderma Announced

announced yesterday, positive results from its Double-Blind Placebo-Controlled Phase II Clinical Study evaluating the safety and tolerability of AIMSPRO given as a monotherapy to patients with Late Stage Established Diffuse Cutaneous Systemic...

» Cancer Drug Shows Promise For Treating Scleroderma

A drug approved to treat certain types of cancer has shown promising results in the treatment of patients with , according to results from an open-label Phase II trial. While the drug's efficacy must be demonstrated in a Phase III trial, the gold...

» Rare Diseases Day

Febuary 28th, 2010 was Rare Diseases Day, and it was marked with a variety of events and activities all over the world - as well as with plenty of citizen media and online participation. The goal was to raise awareness about so-called. These are...

» What Causes Scleroderma?

Collagen is a group of naturally occurring proteins, found exclusively in animals and especially in the flesh and connective tissues of mammals. It is the main component of connective tissue, and is the most abundant protein in mammals, constituting...